Lumineers® (ultra-thin porcelain veneers) -

When a dentist places porcelain veneers for a patient, they have some options as to the specific protocol they use.

One of these is the no-shots/no-drilling technique that's possible with ultra-thin veneer products like Lumineers®. Dentists refer to this as "no tooth preparation" (or simply "no-prep") placement.

Lumineers® can be placed without "shots" and drilling?

That's right. The idea is that ultra-thin porcelain veneers are so thin that they can be bonded directly to the surface of a tooth without needing to trim it back first. Since no drilling is involved, an anesthetic isn't needed either.

How thin are they?

Ultra-thin laminates are generally defined as those that can be crafted to tolerances as thin as .2 to .3 millimeters. That's less than 1/64th of an inch, and similar to the thickness of a contact lens.

Vs. regular veneers.

In comparison, the minimal thickness for a conventional porcelain veneer typically lies on the order of at least .5mm. And while that might not seem like much of a difference, keep in mind that we're discussing the situation where extra thickness is added to a tooth.

Adding bulk to a tooth has consequences, so anything that can be done to help to keep the added amount to a bare minimum has benefits, hence the advantage of a product like Lumineers® in this type of application.

Conventional veneers vs. Lumineers®.

It's the thinness of Lumineers® that makes them unique.

What exactly are Lumineers®?

a) Vs. other ultra-thins.

There are several brand names associated with the subject of no-prep, ultra-thin porcelain veneers. Lumineers® (DenMat Holdings) is simply one of these brands.

While it's probably the best known one (due to both its extensive advertising campaigns and having been on the market the longest), there are some equivalent products. They include Vivaneers® (Glidewell Laboratories) and DURAthin® (Experience Dental Studio).

On our pages we tend to refer to all ultra-thin products as Lumineers®, since so many people are already familiar with them. But this procedure has developed into it's own technique. It's no longer just about one dominant brand, equivalent products exist and can be used in identical fashion.

b) Vs. other veneers.

One thing that makes the Lumineers® brand unique is that their veneers are made out of Cerinate® porcelain (DenMat Holdings).

This product is exceptionally strong and that characteristic helps to make it possible for these veneers to be so thin. Cerinate® products are only available to dentists through one of DenMat's Smile Design Studios®.

Details about no-tooth preparation placement.

One thing that makes ultra-thin laminates special as compared to conventional ones is that placing them doesn't necessarily have to require any tooth preparation (trimming).

That means the patient avoids both the use of a dental drill and getting any shots. (There are some other procedural advantages to this technique too, see lower on this page.)

General advantages of no-prep vs. conventional placement.

Tooth conservation.

The fact that no tooth structure is trimmed away makes no-drilling placement one of dentistry's most conservative procedures, and opens the door for what could be termed benign elective cosmetic dentistry.

("Benign" in the sense that teeth are not harmed, and in theory the procedure is a reversible one [although possibly only in theory]).

Nothing to fear.

No requirement for tooth trimming makes this procedure ideal for people who want to make a change but are generally fearful of having dental work performed.

Minimal tooth sensitivity.

Since treated teeth remain generally undisturbed, post-placement sensitivity is seldom a problem. This isn't always the case with conventional veneers.

A very secure bond is created.

No-preparation veneers are bonded directly to tooth enamel and this is the strongest, most predictable and lasting type of bond created in dentistry.

In comparison, during the trimming process that takes place with conventional veneering technique it's possible that some of the tooth's dentin will be exposed (the tooth layer under enamel). Bonding to dentin is less secure than enamel.

Better, not best.

Even with all of these advantages, this technique does have disadvantages and criticisms. So it's probably best said that versus conventional veneers, no-preparation placement isn't better but simply different. (It has different preferred applications, see below.)

How are no-preparation Lumineers® placed?

In terms of what the procedure involves, here's how no-drilling protocol (the one that can be used with ultra-thin laminates) compares to traditional veneering technique.

A) Conventional placement.

When traditional porcelain veneers are made, the dentist will first grind away some of the front side of the tooth. (See picture "A" in our graphic.)

Conventional veneers vs. Lumineers®.

They'll usually only need to trim an amount that's about the same thickness as the laminate they plan to place.

And although that's just a very slight amount:

The patient will have to endure the drilling process.

An anesthetic will probably be required.

Temporary veneers will likely need to be worn until the next appointment when the final restorations are cemented.

For more details, use this link for an overview of the steps a dentist follows when placing conventional porcelain veneers.

B) No-shots, no-drilling veneer placement.

Since ultra-thin products like Lumineers® can be made wafer thin, they can be bonded right onto a tooth's surface without unduly increasing its size (see picture "B" in our graphic).

That means:

There's no need for any tooth preparation, thus allowing the procedure to be generally painless (no anesthetic "shots" are needed).

The dental work involved with the procedure's first appointment is quick and comparatively easy. It can be as simple as just polishing the teeth so they're good and clean and then taking a dental impression. Really.

No temporaries are needed. Unlike with conventional technique where temporary veneers are sometimes needed to cover the patient's trimmed teeth (because they may be rough, sensitive or unsightly), with no-drilling protocol they are never required.

But all of this simplicity comes with trade offs. And you should know that not all dentists think that the use of this technique creates the best results. And in fact, for decades there's been continued heated debate in the dental community about if and when a no-drilling approach makes an appropriate choice.

One last point about no-shots veneer placement.

As just mentioned, no-drilling, no-shots Lumineer® placement has some disadvantages associated with it. One of these is that the veneers often need to be relatively thick at their gum line edge so to adequately mask over the tooth structure underneath. Unfortunately, this configuration makes it more difficult to remove gum-line dental plaque.

This problem can be minimized if the dentist is able to finely taper and extend the edge of the veneers underneath the gum line (where their inability to mask the tooth won't show). But doing so typically requires retracting (pushing back) the gums right before the impression is taken.

Placing retraction cord usually pinches.

This step involves packing "retraction cord" (small diameter yarn) between the gum tissue and the tooth. And usually this process pinches a bit, to the point that anesthetic (a shot) is usually given.

So if experiencing dental injections is not a big issue for you, allowing them will probably aid in creating the best outcome for your case possible. (You'll still reap the benefit of no tooth trimming.)

Actually, Lumineers® can be used with either protocol.

We're not trying to confuse the issue here but the following point needs to be made.

Lumineers® (and similar ultra-thin products) can be placed using either traditional or no-prep technique (the two techniques discussed above).

Just because they can be made to wafer-thin tolerances (.2 to .3 mm in thickness) doesn't mean they have to be.

They can be made to conventional dimensions too (.5 mm thickness or more).

That makes them possible to place no matter what the patient's case (or even individual teeth involved in the case) calls for.

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C) Minimal-prep veneers.

As yet another variation, dentists have the option of placing ultra-thin veneers using minimal-tooth preparation technique.

This procedure is defined as the situation where the tooth is trimmed down, but less so or less extensively than it would when using conventional placement protocol. (Typically .3 to .5 mm vs. .5mm or more for conventional veneers.)

Advantages.

The patient still reaps some benefits (minimal drilling, likely no "shots," no need for temporaries, etc...). Yet by trimming back the most prominent portions of each tooth, the dentist can create a better functioning or more aesthetically pleasing end result than they could with no-drill technique.

Minimal-prep brand names.

Each of the ultra-thin veneer brands mentioned above (Lumineers®, Vivaneers®, and DURAthin®) can be placed using minimal-prep technique. MAC® (MicroDental Laboratory), daVinci®, and IPS e.max veneers are suited to this type of placement too.

Success has a lot to do with proper case selection.

People who know about products like Lumineers® typically do so because of advertisements they have seen. Unfortunately, ads can lead a consumer to form unrealistic expectations.

Most people understandably draw the conclusion that the use of no-drilling technique can be used in their situation. And while in theory this may be true, any dentist can tell you that there's often quite a bit of difference between what's technically possible and what's in the patient's best interest.

In reality, ultra-thin products like Lumineers® are best used just to make simple upgrades and enhancements for teeth.

Who makes the ideal candidate?

When a veneer is placed without trimming the tooth first, the tooth will end up being at least some degree larger.

In order to avoid the situation where this change is enough to create problems, a dentist will look for applications where:

Only minimal changes are needed (so the laminate can be as thin as possible).

Any resulting increase in tooth size can be used as an asset.

Favorable applications for no-prep veneers.

In general, here are the kinds of situations that make the most ideal applications for no-drill laminates like Lumineers®.

A) Making minor color changes.

Background.

Veneers lighten teeth by simply covering over and masking the darker tooth structure that lies underneath. There are two ways an effective amount of masking effect can be created.

1) When using comparatively translucent veneers.

When a veneer is fabricated using relatively translucent porcelain (doing so tends to give the tooth a more life-like appearance), it will need to be comparatively thicker, so it can effectively mask the color of the tooth underneath.

This is the approach used with conventional placement technique. The tooth is trimmed back so a thicker/more translucent veneer can be placed without creating a result that's too bulky or oversized.

Ultra-thin veneers are best for making just small color changes.

2) When using comparatively opaque veneers.

In cases where ultra-thin veneers are placed, the only way to get the needed amount of masking effect is to use porcelain that's relatively more opaque.

The problem is that more opaque veneers typically look more artificial. (This is a criticism of Lumineers® and similar products in general. We discuss it here.)

Appropriate applications.

By limiting the use of no-drill technique to just cases where only a minor amount of color change is needed (such as lightening teeth just a shade or two, or masking slight blemishes), the veneer can be both ultra-thin yet comparatively less opaque (win-win).

B) Making minor alignment changes.

Background -

Veneers can be used to even out the apparent alignment of teeth. But not trimming back portions of the most prominent ones first (which is the case with no-drill technique) can result in an outcome where the restorations make the teeth very thick. (We illustrate and explain this issue here.)

Appropriate applications.

Think of no-prep veneer placement as a way of tweaking and perfecting a smile, such as correcting minimal tooth misalignments or straightening out minor incisal (biting) edge discrepancies. Not as a substitute for involved orthodontic work.

C) Closing tooth gaps (diastema closure).

Since placing no-prep veneers ultimately increases the size of the patient's teeth, any time this change can be used as an asset makes an ideal application for this technique.

Dentists sometimes refer to these types of situations as "additive" cases.

Appropriate applications.

Probably more so than with any other type of case, patients who have spaces between their teeth frequently make good candidates for no-tooth preparation veneers. Even more so if the teeth involved are relatively small or lingually inclined (see next section).

The extra thickness of a Lumineer® would be a benefit for this tooth.

D) Enhancing the appearance of small or inclined teeth.

Background -

This is another class of "additive" cases, meaning situations where the added bulkiness that results when no-tooth preparation veneers are placed can be used as an asset.

Applications.

Improving the look of comparatively small teeth. (Such as improving the appearance of "peg" laterals, or teeth that need a minor amount lengthening.)

"Straightening" the alignment of lingually inclined teeth. (Teeth that are tipped inward or backward as opposed to being flared out.)

As with the other examples given on this page, just relying on the veneer to make minor improvements is typically the key to a successful outcome.

E) Minor repairs.

Applications -

Teeth that have small chips, minor wear on their biting edges or an irregular outline form can make appropriate candidates for no-drill laminate placement.

As with all veneering techniques in general, just improving the appearance of the tooth should be the goal. Other types of restorations (especially dental crowns) make a better choice for rebuilding or strengthening damaged teeth.

F) Masking existing fillings.

Applications -

White fillings (dental composite) tend to deteriorate and stain over time. Placing ultra-thin, no-prep veneers over these types of restorations can provide a more aesthetically pleasing and durable tooth surface.

What about when precisely perfect conditions don't exist for Lumineers®?

Even if your dentist determines that your case really isn't the perfect application for an ultra-thin/no-drilling approach, it doesn't necessarily mean that choosing it always makes an absolutely terrible decision.

Weigh the pros and cons.

For some people, the convenience or reduced level of dental fear associated with no-drill placement may far outweigh the drawback of a slightly less than ideal outcome.

When it comes to aesthetics, lots of people seem willing to accept the compromises generally associated with ultra-thin veneers.

But when the concerns are functional and biologic in nature, the choice to proceed with ultra-thins can be expected to be a poor one. (Details and examples.)

Beware of case rationalization.

Going ahead and placing no-prep veneers when less-than-ideal conditions exist is frequently rationalized as being acceptable by both patients and dentists alike. But before choosing this route, it's critical to have thoroughly discussed matters with your dentist so you understand all of the possible short and long term consequences of doing so.

The use of no-prep veneers for cases that lie outside of accepted norms is precisely when this technique is most likely to create a compromised outcome (in terms of appearance, function, maintaining dental health and case longevity).

Ask about seeing a diagnostic wax up.

Especially in cases where there seems to be some question about the appropriateness of placing no-preparation Lumineers®, dentists will frequently have a diagnostic wax up made.

A wax up gives you a chance to see the outcome of your Lumineers® case beforehand.

Your dentist will take impressions of your teeth, from which plaster casts are created.

A dental laboratory technician will then add wax to your casts to simulate the placement of ultra-thin veneers.

Doing so provides you with a 3-dimensional representation of your completed case to view, touch and examine from all sides and angles. (For example, you can evaluate firsthand how much thickness your ultra-thin veneers will add to your teeth, or how oversized they will become.)

You can discuss any issues you notice with your dentist. If they can't be resolved, then clearly that's a sign that conventional veneering technique makes the better choice for your case. Or if satisfied, you can give your approval.

Lumineers® vs. conventional veneers - Which makes the better choice?

Of course, only you and your dentist can make this determination. But by answering the following questions we can point out many of the important issues that need to be considered when choosing between conventional or no-drilling (Lumineers®) placement protocol.

Is dental fear an important factor?

Yes

Are you most fearful of -

Everything dental.

If placing Lumineers® can produce an acceptable enough result, beyond no need for tooth trimming or dental shots, no-drilling protocol also offers the advantage of shorter, simpler appointments.

Dental drilling.

If this is your main concern about having dentistry performed, then when it can provide results that are acceptable enough, no-drilling technique makes the easy choice.

Getting dental shots.

If it's only getting shots that you're concerned about, quiz your dentist. In many cases the small amount of tooth trimming that's required for conventional veneer placement may be minor enough that no anesthetic is needed.

What kind of results do you want?

The whitest teeth possible.

One difficulty associated with no-drill Lumineers® is that their ultra-thin nature frequently means that they must be fairly opaque to be able to adequately mask the natural tooth structure that lies underneath them.

If you're willing to accept the look of very opaque veneers ("Chiclets" uniformity, no characterization), then even ultra-thin Lumineers® can probably be used to produce the color change you want, even bleach white.

The most life-like results.

Natural teeth exhibit luster, a degree of translucency and individual tooth characterization. In most cases its the goal of the dentist to create restorations that mimic these characteristics (so to obtain the most life-like results possible).

Toward this goal, it's easier to accomplish this task with a thicker rather than thinner veneer (which implies that some tooth trimming will be needed). This page explains.

How many teeth will be treated?

Just a few.

In cases where only one or just a few isolated veneers will be placed, a dentist may need all the help they can get in being able to perfectly match the color and characterization of the adjacent teeth.

If so, a comparatively thicker veneer (like that placed following tooth trimming) makes this task easier as opposed to an ultra-thin Lumineer®. (See the "What kind of results do you want?" boxes above.)

4, 6 or more.

Smiles are more likely to look normal and pleasing to other people if they display left-right symmetry.

So with cases where using no-drill protocol might result in a reasonable but lesser aesthetic outcome (see the "What kind of results do you want?" boxes above), if the veneers are placed either all across, or else if 2, 4 or 6 are placed as matching left-right pairs, the shortcomings of the case might be fairly unnoticeable because the smile displays symmetry.

Will undergoing dental work interrupt your lifestyle?

Yes

Once your teeth have been trimmed for conventional veneers, one of two scenarios will play out:

Temporary veneers will be placed. Worse-case outcome- They may not look realistic or stay in place well.

No temporaries are placed. Worse-case outcome- The patient is left with roughened, irregular-looking teeth that have some sensitivity.

If you have a lifestyle where your smile is constantly scrutinized, you may not want to take a chance with dealing with the above. If not, no-drill Lumineers® avoids the potential for these difficulties altogether because your teeth remain unchanged until the day your new restorations are placed.

Are your teeth crooked?

Yes

Conventional veneer placement tends to make the better choice for cases where an improvement with tooth alignment is needed. Here's why.

No

Either method can make a good choice.

Are your teeth very dark?

Yes

When a relatively large shade change is needed, it's typically easier for a dentist to produce a natural-looking result with conventional, thicker veneers.

To get the same outcome, no-drill Lumineers® would need to be relatively more opaque. And this can result in a less life-like tooth appearance.

No

Either method can make a good choice.

Do you have tooth gaps or undersized teeth?

Yes

Either method can make a good choice. But of all of the different types of initial conditions, this is the one that's most favorable for no-drill Lumineers® placement.

How's your oral home care?

As an elective procedure, neither veneers nor dental work of any type should be considered. By having restorations placed, you're simply setting yourself up for the potential for a lifetime of dental problems, including tooth decay and periodontal (gum) disease. (The link below explains.)

In the case where some type of veneer is required, conventional placement (where the tooth is trimmed before the veneer is placed so no change in tooth size or shape occurs) typically makes the better choice. This page explains.

Rejuvenating the appearance of porcelain dental work with Lumineers®.

Placing no-drill Lumineers® is sometimes promoted as a way to improve the appearance of porcelain-surfaced crowns and bridges that are no longer aesthetically pleasing. Other ultra-thin veneer products might be used in the same way.

Lumineers® can be used to rejuvenating the look of a deteriorated porcelain crowns.

The idea is simply one where the veneer is bonded directly onto the front porcelain surface of the restoration, thus giving it a new look.

Since doing so only creates a cosmetic change, the dentist must examine the dental work in question and make sure that it's otherwise intact and clinically satisfactory.

Is using this technique a good idea?

One needs to keep in mind that this is patchwork dentistry.

Rather than having a restoration that's just a single entity created in the controlled environment of a dental laboratory, you'll instead have "a restoration placed on a restoration" that's been assembled in your mouth.

a) With dental crowns.

If your dentist suggests this type of repair for an individual crown, ask about their rationale.

They may have valid reasons. But in most cases your cost and number of appointments needed for the work will probably be about same for either approach, with the crown remake having the more predictable long-term outlook.

b) With dental bridges.

It's easier to see the benefits of this technique when bridgework is involved. Veneering just one or a few teeth that have spoiled the appearance of a large-span bridge might offer a practical solution, at just a portion of the cost of replacing it.